Chorioamnionitis

Chorioamnionitis or intra-amniotic infection is a complication affecting about 1-2% of pregnancies and typically occurs towards the end of a long labor. The infection is most often caused by bacteria such as E. Coli or Group B Streptococci that overcome the natural antimicrobial agents in the vaginal canal, cervix, and uterus and get into the amniotic fluid surrounding the growing baby. Symptoms of Chorioamnionitis will include fever of greater than 100.4ºF, a rapid heart rate in the mother and/or baby, foul-smelling amniotic fluid or vaginal discharge, uterine tenderness, and elevated numbers of white blood cells in the mom-to-be. If more than two of these signs or symptoms are present, there is a greater chance that the baby will have a bacterial infection at birth.

In the United States, women are tested for Group B Strep with a vaginal swab about thirty-five weeks into their pregnancy. A positive result indicates colonization of this bacteria in the vagina and intravenous antibiotics are typically administered during labor to prevent infection. However, diagnosing Chorioamnionitis can be difficult without doing blood testing, as some women present with multiple symptoms from the list above and look unwell, while others are completely asymptomatic and appear completely healthy. ‘Water’ breaking before labor starts is a risk factor for this bacterial infection, as bacteria can more easily enter the amniotic sac once it has ruptured.

Although it is not very common, having a bacterial infection during pregnancy or birth can lead to a newborn with an infection. Therefore it is important to be aware of the signs and symptoms, and report them to your doctor or midwife as soon as you notice them. Also, if you notice any amount of amniotic fluid notify your practitioner, as earlier administration of treatment leads to the best outcome.